NEW YORK (Reuters Health) - In adult patients with traumatic brain injury, treatment with the pregnancy-supporting hormone progesterone may improve outcomes -- especially in cases of moderate injury -- according to a report in the Annals of Emergency Medicine.
"I'd like physicians to appreciate the excitement and hope of finally identifying an agent for the treatment of traumatic brain injury -- and possibly other neurological injuries such as stroke, spinal cord injury, and multiple sclerosis," Dr. David W. Wright told Reuters Health. "No current therapy exists that improves the outcome of brain injury patients."
Wright from the School of Medicine at Emory University, Atlanta, and colleagues conducted a trial to assess the safety and potential benefit of administering intravenous progesterone to 100 patients with brain injury. Patients were randomly assigned to receive progesterone or inactive "placebo."
Brain pressure remained stable in progesterone-treated patients, the authors report, whereas it tended to increase in the placebo group. Increases in brain pressure raise the risk of brain damage.
Progesterone patients remained in coma longer than placebo patients, the report indicates, but just 13 percent of progesterone-treated patients died within 30 days of injury compared with 30.4 percent of placebo patients.
The reduction in death risk seen with progesterone was most prominent among patients with more severe brain injury, the investigators state.
On the other hand, at 30 days, survivors of severe brain injury who had received placebo were slightly less disabled than those who had received progesterone, the report indicates. Patients with moderate traumatic brain injury who had received progesterone were significantly less disabled than those who had received placebo.
Side effects were comparable between the progesterone and placebo groups, the researchers note.
"We are trying to gather enough data to make sense of the 1 year outcomes," Wright said. "So far, we have only been able to assess about 40 percent of the enrolled subjects."
SOURCE: Annals of Emergency Medicine, April 2007.
